Best Practices: Tribeca Wellness Collective
Co-founders (and husband and wife team) Dr. Josh Trutt and Dr. Erica Walters on their integrative wellness approach and why they gather the best available data to offer patients top-of-the-line care.
Dr. Erica Walters and Dr. Josh Trutt don’t adhere to labels. As board-certified emergency medicine specialists, both Dr. Walters and Dr. Trutt found their way to integrative medicine and preventive care after witnessing the inefficacies of standard care. Co-founders of the Tribeca Wellness Collective, this husband and wife team leverage their diverse experience in caring for a wide range of interconnected conditions. Specifically, their interest in cutting-edge science and rigorous research enables them to bring patients the best available treatments in wellness, anti-aging, and disease prevention.
Read on to learn more about their paths to integrative medicine; what makes their wellness practice different; and why they believe a research-heavy, personalized approach is the best way to provide care.
How did you each get started in medicine and how did you choose your specialty?
Josh: In high school, I was surrounded by wealthy kids whose families mostly worked in business. My dad was a math professor at Lehigh University who later worked for Bell Laboratories. Though we were middle class, I didn’t exactly fit in with the wealthier crowds.
When I first started to look at different career paths, my dad gave me the following advice: “All of your friends’ parents work very hard, but there aren’t that many careers where you’ll know that you will have accomplished something every day.” His respect for doctors and their work ultimately encouraged me to look at medicine.
Erica: I was also inspired by my father, who is an emergency physician in Michigan. He was one of the true American cowboys in medicine who saved many lives, including at the start of the HIV epidemic. Watching his career furthered my gravitation toward emergency medicine and also my innate fascination with the human body — I wanted to know why and how things worked.
How do your backgrounds in emergency medicine inform your philosophies around wellness and prevention?
Erica: I went to medical school in Israel, where there is a strong emphasis on prevention and keeping patients healthy before they end up in the ER.
During my residency in the US, I found the lack of preventive care extremely frustrating. I soon realized that I wanted to dive deeper into prevention and wellness, or what is now more often referred to as integrative medicine.
I heard through the grapevine that Josh was an expert in this type of practice and that he was doing something different, so I reached out to gather more information. We met and then he asked me out on an official date. This first meeting sparked my learning in integrative medicine — as well as the start of our lives together.
Josh: For me, the two don’t directly connect. Though I’ve long been interested in integrative medicine, it wasn’t until my grandparents got sick with pancreatic cancer and Alzheimers that I started digging into methodologies that aren’t typically used in Western medicine. My interest in supplements led me to conferences where I found mentors in hormone replacement therapy — and later in stem cell treatments, followed by intravenous vitamin and oxygenation therapies. Soon enough, I realized that the best way to bring this kind of innovative care to patients was to open my own practice.
What inspired you to found the Tribeca Wellness Collective?
Josh: We started Tribeca Wellness Collective to offer a 360-approach to wellness, anti-aging, and disease prevention. Many practices are very limited in their treatments and therapies. We wanted to create a space to merge our passion for integrative medicine with emerging research to offer the best available treatments to our patients.
Erica: Josh is a very research-oriented person, and when he dives into a subject he learns every single thing about it. He’s always going to conferences and learning about new, cutting-edge techniques. Opening Tribeca Wellness has given us the freedom to incorporate these new devices and solutions into our daily practice and build the exact environment that we want to offer our patients.
What makes its approach to wellness different?
Erica: We’re not a cookie-cutter medical practice. Our approach is geared toward personalization and customization. We know that what works for one patient won’t necessarily work for another patient. There’s no one-size-fits-all methodology here.
But our secret weapon is that we are willing to look into whatever technology is out there that could be beneficial. Our team will go to the ends of the earth to figure out exactly what our patients need. Again, this is where Josh’s proclivity for research comes into play. He will spend hours and hours going down rabbit holes of research — which is a rare quality to find in a physician these days.
Josh: A good friend of mine, who is also an acupuncturist and one of the inspirations behind my interest and passion for integrative medicine, once told me that he strongly believed my patients were coming to me for me, and not some fancy technology. It’s been eight years since he first gave me this insight, but I’m just now witnessing that truth in motion — especially since Covid-19. The care and time we put into our relationships with our patients really define our successful and personalized approach.
What kind of role do you think hormone, peptide, and regenerative therapies can play in longevity and overall preventive care?
Erica: They are definitely the cornerstones of our practice, but they’re just a piece of the puzzle. When you start to put all the pieces together, you realize that there’s isn’t just one smoking gun. You have to take into account the holistic story and history of each patient in order to prevent diseases of aging and improve quality-of-life. That last part is especially important because nobody wants to live to 120 if their quality of life will be dramatically low.
To give a personal example, my grandmother, who was a Holocaust survivor, lived until she was 89. Her mind was sharp as a tack and she was very quick-witted — she’d always give me a piece of her mind if she thought I needed more lipstick — but her back was twisted from malnutrition in the camps, and as a result she suffered from terrible osteoporosis. Had her back been treated when she was 40 or 50 years old, we could have potentially prevented her osteoporosis. Instead, she lived with that excruciating pain. At Tribeca Wellness, we work to improve the quality of life as our patients age, so they can enjoy long, happy, and healthy lives.
In what ways has Covid-19 changed how you treat patients?
Josh: When the office closed at the start of the pandemic, we transitioned to only having contact with patients via phone. It was then that I realized that patients don’t really care about which technologies you use, but they do care about having a doctor who will listen to them and be present. In that way, how we treat our patients hasn’t changed. However, I will say that though we were using telemedicine long before Covid-19, we’re using it now more than ever, and incorporating video calls, too.
Erica: We were very busy during the first few months of Covid-19. We had long days speaking to patients who really needed someone to talk to and who could explain what was going on. We started putting out a newsletter with the most up-to-date research that we were finding to help our patients get reliable information. So many of them reached out to thank us because identifying reputable news sources had been very difficult.
We’ve also increased our focus on supporting our patients’ immune systems. We use peptides, supplements, exercise, and diet recommendations, but we’re also encouraging our long-term membership patients to have consultations with our naturopath, Dr. Mark Iwanicki. Dr. Iwanicki can do things that we can’t, like homeopathy, herbs, acupuncture, and cupping — techniques that have been shown to support the immune system and decrease stress.
Can you tell us about your startup, Curos, and how you expanded that project to address Covid-19 and immunity?
Josh: Curos is a data-processing startup that I created to help bring my practice to the masses. I found that a lot of the direct-to-consumer genetic tests, and even some of the tests offered by practitioners, included very incomplete information. So I set out to create the best genetic test out there that would take into account a person’s lifestyle—so that you can see how those genetics are being manifested, and how they look alongside their lab results — to create one complete and comprehensive report.
When Covid-19 hit, we took a left turn to help provide access to supplements that most people had trouble finding in-stock online. I used our platform to put these supplements into one pack that I could send out to people quickly. It was a small but efficient way to help provide extra immune support when people needed it most.
Separately, you’ve also been working with an antibody company based in Switzerland. Can you tell us more about that?
Josh: Right now, researchers, scientists, and doctors all over the world are trying to gather information as quickly as they can to share updated best practices on Covid-19 — particularly when it comes to accurately collecting and testing antibody data.
Even at baseline, antibody tests are imperfect for most diseases. With Covid-19 specifically, the antibodies don’t rise in a pattern that’s fully expected. Additionally, depending on where they come from, some tests are less reliable than others.
Interestingly, the New York Times recently published an article on available antibody tests and highlighted the top three from their research. We then dug into their top five and discovered that all of them came from the same factory in China, even though they were sold under different names.
Why, then, were people getting such different results with tests that come from the same factory? In searching for alternatives, I found a Swiss company called Spring Healthcare, which had experienced similar problems with unreliable raw materials from a Chinese factory and had since switched to sourcing antibodies from Germany.
Out of all of the companies we had spoken to, Spring Healthcare was the best option for a reliable product, so we decided to partner with them to source antibody testing for our patients.
Are you still performing these tests?
Josh: Yes, in specific use-cases. Over the course of the time that it took for Spring Healthcare to ramp up production of their kits, new information came to light in regard to the efficacy of antibody tests.
Specifically, we learned that Covid-19 antibodies tend to surface between 15 and 21 days after becoming infected, but then fade between 45 and 50 days after you first start showing symptoms. This may be because antibodies at that stage are too low to be detected. However, if exposed again, current data suggests that it’s possible that antibodies would surface much faster the second time around, giving partial immunity. But we don’t know that for sure. Ultimately, this becomes a huge problem when trying to track cases of people that may have been infected three, four, or even six months ago.
By the time the tests arrived, this new information sparked an important conversation on whether people should be doing antibody testing at all.
As of now, we use the tests on anybody who comes into our office because if their IgM antibodies are elevated, that implies that they may still be contagious (and will need to get a Covid-19 virus test), whereas elevated IgG antibodies imply that they’ve had it already.
How do you think the events of the past several months will shape the future of wellness?
Erica: We’ve seen how Covid-19 is primarily a disease of the unhealthy and that people with metabolic diseases are predominantly experiencing the worst cases. I hope that this is a big wake up call for a lot of us that we need to take better care of ourselves.
Josh: I think telemedicine is going to take over. As physicians, we’ve all experienced how crucial and easy it is to build a successful relationship with patients using telemedicine — and in some cases exclusively using telemedicine — and I don’t think that demand is going to subside anytime soon.
Erica: I also believe that pharmacies like Capsule are the way of the future. New, tech-savvy companies that are able to rapidly adapt to the shifting climate will continue to thrive. We know that people are less likely to leave their homes for pointless errands right now because of the threat to their safety. But even as that barrier lifts, who will want to go back to jumping hoops between prior authorizations and pharmacy turnarounds? Services that are seamless, easy, and fast and that make our patients’ lives easier are services that we’re going to keep using for the long-haul.
Vital Signs
What’s your go-to anti-aging tip?
Erica: The easiest, cheapest, and best thing you can do for yourself is to exercise.
Josh: Yeah, you can’t beat diet and exercise. It’s a boring answer, but it’s the truth. Also, be mindful of your sugar levels. For fun, I bought a continuous glucose monitor and am learning that a lot of the foods that I thought were good for me, like green juice or a handful of grapes, are actually spiking my sugar levels.
Erica: Yes, it’s eye-opening to think about these foods from a different perspective.
Josh: Also, put your phone away!
Favorite place for a walk in NYC?
Erica: We’ve just discovered the secret waterfall in The Ramble in Central Park. It’s very special and our son absolutely loves it. If we’re not at the office, we go there every day.
Josh: Just make sure to leave your phone at home when you go for a walk.
TV show that you’re loving right now?
Erica: We loved Chernobyl on HBO. It was completely riveting, and mindblowing to know that it was based on a true story.
Josh: It also felt very meta to watch a show about a catastrophe as we’re living through one.
What’s one healthful habit you’d love to see patients adopt?
Josh: I just started looking into a method called Buteyko Breathing, which teaches you to breathe through your nose all the time, rather than through your nose and mouth. This method aims to slow down your breathing, make you more tolerant of higher levels of carbon dioxide, and help with anxiety. What’s more, there have been studies that show negative ramifications of mouth breathing on long-term health. Look to practitioner Patrick McKeown for some great resources online on how to get started.
